**4. Folate, folic acid or B9**

The term folate includes 150 components of the family of pteroilglutamate, which participate in cell replication by enzymatic activity in purine base synthesis for DNA and are a primary co-factor for transamination in the transformation of amino acids, particularly homocysteine into methionine. Folates are present in animal tissue, leafy vegetables, legumes and nuts and their deficiency has been associated to megaloblastic anemia, neural tube defects, cardiovascular disease, cancer and senile dementia [41].

Implication of folate in pathogenesis of type 2 DM is linked with vitamin B12 shortage and its consequent hyperhomocysteinemia, and although its deficiency is not widespread, supplementation trials have been carried out in diabetic patients [42].

Folates are made up of 4[(2-amino-4-oxo-1,4-dihydropteridin-6-yl) methylamino] benzoic acid, pteroic acid which is bonded with multiple or single monomers of L-glutamate. They lie in the family of heterocyclic organic compounds group [43].

There are eight different types of B vitamins. They are collectively called as B complex vitamins. Folate i.e., Vitamin B9 is also one of them. The naturally present folate forms are also based on vitamin B9. Many of the foods contain B vitamins. Many of folates are also taken from foods. They are generally made up of a mix of reduced folates. Reduced folates are any type of pteroyl mono glutamates, or an amalgam of pteroyl glutamates. They have a peculiar degree of pteridine ring reduction. Also, they have a different number of glutamates remains and one-carbon replacements [44]. The seven of total eight B vitamins can dissolve in water and hence cannot be kept by our body. We must constantly get their supply in our daily diet. Folates (vitamin B9) have that property. We can get them from

**379**

*Therapeutic Effect of Folate and Cobalamin in Diabetics DOI: http://dx.doi.org/10.5772/intechopen.96447*

vitamin B12 deficiency [47].

S-adenosylmethionine [51].

**4.2 Inadequacy**

**4.1 Roles**

foods like beans (and other legumes), salmon, citrus fruits, whole grains, leafy vegetables, meat and dairy etc. If we fail to fulfill our need of folate form our daily diet then we can take supplements which contain artificially synthesized folate to fulfill our needs. Folate fortification is also done to increase the folic acid intake by people. A number of commercially sold synthetic forms of folates are even better as compared to the natural ones [45]. They could be easily broken down chemically, especially reduced type of unsubstituted tetra and di-hydro forms are chemically stable. Tetrahydrofolates are usually found as the unsubstituted poly glutamates and tetrahydrofolates, that is, 5-methyl, 5,10-methylene, and 10-formyl etc. [46]. Reduced substituted forms of vitamins are prone to the chemical changes. Oxidative reactions occur in them which results in the activeness loss of vitamins. There are no acknowledged undesired effects of folates. An excess intake of them is not dangerous for human beings. The maximum usage limit of synthetic folates is capped to 1 mg daily. It is advised because excessive administration of folates may cover up the

Folic acid is considered to be an essential nutrient for our body. Folic Acid derivatives are necessary components for the DNA production. They are also needed for the erythrocyte synthesis. The biosynthesis of some amino acids needs tetrahydrofolates as a crucial ingredient. They are needed in the biosynthesis of precursors of DNA also [48]. Folic acid is necessary for the production of deoxyribose nucleic acid (DNA). They even aid maintenance of the process of methylation [49]. They also participate as helper molecules in some biological reactions. The cell division in our body essentially needs folate. We need it even more during pregnancy and infancy. It is needed in multiple crucial processes like quick cell growth and proliferation. The production of RBCs also needs folate. This acts to keep from anemia [50]. Nucleotide synthesis is the most important function of folate. It is required for the production and repair of DNA. Folates are also responsible of the production of methionine by alteration of Homocysteine in the procedure of re-methylation. Methionine is a useful amino acid which is in turn used to produce other necessary proteins. It may get converted to an important methyl donor i.e.,

The deficiency of folate is not common in developed countries. But it is reported in many of the third-world countries. Folate deficiency could be due to multiple reasons. The poor diet and erroneous metabolism of vitamins could be responsible for it [52]. The US government along with that of many other countries has made fortification of food with folate to be mandatory for their nationals. This helps in eradication of NTDs worldwide. Mostly they use floor for the fortification because it is widely used by the public. The routine ingestion of folate is examined by taking the blood samples and measuring the folate levels in them. If the level of folate is low in blood samples then it means the folate is not taken up to required level [51]. We can fulfill our folate requirement by taking folate fortified diet. Artificial folate supplements are also available in the market which can serve the purpose. But the availability of any of the options of folate intake vary in different regions of world. The folate absorption also differs for every supplement used. Dietary Folate Equivalent (DFE) is the amount of folate our body can absorb out of the supplement taken per serving. Every DFE unit is considered to be one micro gram of

folates or 0.6 micro grams of artificially made folate [50].

#### *Therapeutic Effect of Folate and Cobalamin in Diabetics DOI: http://dx.doi.org/10.5772/intechopen.96447*

foods like beans (and other legumes), salmon, citrus fruits, whole grains, leafy vegetables, meat and dairy etc. If we fail to fulfill our need of folate form our daily diet then we can take supplements which contain artificially synthesized folate to fulfill our needs. Folate fortification is also done to increase the folic acid intake by people. A number of commercially sold synthetic forms of folates are even better as compared to the natural ones [45]. They could be easily broken down chemically, especially reduced type of unsubstituted tetra and di-hydro forms are chemically stable. Tetrahydrofolates are usually found as the unsubstituted poly glutamates and tetrahydrofolates, that is, 5-methyl, 5,10-methylene, and 10-formyl etc. [46]. Reduced substituted forms of vitamins are prone to the chemical changes. Oxidative reactions occur in them which results in the activeness loss of vitamins. There are no acknowledged undesired effects of folates. An excess intake of them is not dangerous for human beings. The maximum usage limit of synthetic folates is capped to 1 mg daily. It is advised because excessive administration of folates may cover up the vitamin B12 deficiency [47].
